The most complete dialectical analysis of TCM in children with diarrhea!
Western medicine calls diarrhea diarrhea, and those who develop it in infants and young children call it diarrhea.
The disease is most common in children under 2 years of age.
Although it occurs throughout the year, the incidence increases in summer and autumn, and the diarrhea in autumn and winter is likely to cause epidemics.
In children, the spleen is often inadequate, feeling deficient, suffering from internal injury, milk feeding, or spleen and kidney yang deficiency, which leads to dysfunction of spleen and stomach transport and diarrhea.
Mild patients are treated properly and have a good prognosis.
In severe cases, excessive discharge is easy to see, and qi and yin injuries are easily seen, and even yin is exhausted.
Those who have not been cured for a long time can easily turn into false evidence or experience slow convulsions.
[病因病理] 小儿泄泻发生的原因，以感受外邪，内伤饮食，脾胃虚弱为多见。Its main metabolism is in the spleen and stomach, because the stomach accepts the rotten water, and the spleen mainly transports the water and valleys. If the spleen and stomach are diseased, the diet enters the stomach.Into diarrhea.
Therefore, “Children’s Integration · Diarrhea Treatment” said: “The essence of a husband’s diarrhea is due to the spleen and stomach.
Covering the stomach is the sea of water valleys, and the spleen is transported to make the spleen healthy, and the water valleys are corrupted into qi and blood to honor Rongwei.
If the diet is out of step and the cold temperature is not adjusted, which causes the spleen and stomach to be injured, the water is wet, the valley is stagnation, the essence of the gas cannot be lost, but the pollution is reduced, and the diarrhea is ridiculous.
“Feel the viscera of the external evil child tender and delicate, the skin is weak, the cold and warm are not self-regulated, and it is easy for the external evil to attack the disease.
Exogenous wind, cold, summer, wet, hot evil almost cause diarrhea, but no dry evil causes diarrhea, cover because of the spleen like dry and wet.
Other external evils often cause diarrhea in combination with wet evils, so the predecessors have said that “wetness does not result in diarrhea” and “wetness becomes five diarrhea.”
Due to climate factors, wind and cold (wet) cause diarrhea in winter and spring, and summer (wet) cause diarrhea in summer and autumn.
Pediatric diarrhea is most common with hot and humid diarrhea.
Children with internal injury diet often have insufficient spleen, weak transport ability, and unconscious diet. If care is not appropriate, breastfeeding is improper, diet is unclean or unclean, eating raw cold fruits or indigestible food can damage the spleen and stomach, and diarrhea occurs。Therefore, “Su Wen Bi Bi” said: “Dietary self-doubling, the stomach is hurt.
“Injury, food and diarrhea can occur alone, more often than in other diarrhea syndromes.
Weakness of the spleen and stomach Congenital endowment is insufficient, acquired care is not appropriate, or prolonged illness does not heal, can cause spleen and stomach weakness.
The weak stomach is stale, and the spleen is dysfunctional, so the water is wet, the valley is stagnation, the turbidity is not divided, and the spleen is down, causing spleen deficiency and diarrhea.
There are also empirical evidence of diarrhea, mistreatment, failure to heal, and damage to the spleen and stomach.
Spleen and kidney yang deficiency caused by spleen deficiency, generally consumes the temper first, and then damages the spleen yang, the spleen damage and kidneys after a long time, resulting in spleen and kidney yang deficiency.
Insufficient kidney yang, fire does not warm the soil, cold and cold inside, water valleys do not change, and walks between the intestines, resulting in clear and cold, spleen and kidney yang due to holes and diarrhea.
Because children have the physiological characteristics of “naive yin and yang,” and the pathological characteristics of “easiness, weakness, coldness, and heat,” and when the diarrhea is severe, they can benefit too much, and easily damage the gas and fluid.Two injuries of yin, even yin injury and yang, lead to the critical change of yin exhaustion.
If the long-term diarrhea does not stop, the soil is weak, the liver is uncontrollable, and the wind is uncontrollable. Slow convulsions can occur; the spleen is debilitated, the biochemical fatigue is weak, and the blood is not enough to honor the viscera and skin.
[临床诊断] 一、诊断要点 1。
The number of bowel movements increased more than 3-5 times a day, and more than 10 times a day, and it was pale yellow, such as egg flower soup, or yellow and green, or brown and stinky, with a small amount of mucus.
Or accompanied by nausea, vomiting, abdominal pain, fever, thirst, etc.
Have a history of malnutrition, unhealthy diet or feeling sick.
Severe diarrhea and severe vomiting can be seen with lack of urine, elevated body temperature, tiredness, dry skin, depression of the cardia, visual depression, dehydration such as crying without tears, and red lips and lips, deep breathing, and abdominal distension and other acid-base balanceImbalances and manifestations of electrolyte disorders.
Stool microscopy may have unfortunate bulbs or a small amount of white blood cells and red blood cells.
5, stool stool examination may have pathogenic colon or virus test positive.
Second, the differential diagnosis of dysentery is that the stool is thin, there is sticky frost or pus and blood, the stool is increased after the emergency, and abdominal pain is obvious.
Stool routine examination of red blood cells, white blood cells are many, phagocytic cells can be found; stool culture has dysenteriae growth.
[辨证论治] 一、辨证要点 1.
Differentiating the etiology can lead to different syndromes and different stool traits.
Generally, the stool is thin and contains milk clots or food residues, the smell is sour, or if the eggs are broken, it is mostly caused by wounds and food.
Stools are thin and foamy, yellowish in color, and have a bad smell, mostly caused by wind chills.
Watery or egg flower soup-like stools, large amounts, yellowish brown, stinky odor, or slight mucus, abdominal pain, mostly caused by hot and humid.
Stool is thin or mushy.
The color is light and not stinky, and it is caused by spleen deficiency after eating too much.
The stool is thin, the valley is not changed, the color is light and odorless, and most of them are spleen and kidney collapse.
The number of discerning light and heavy stools is generally not more than 10 times, the spirit is good, there is no vomiting, and the amount of urine can be regarded as light evidence.
Urgent diarrhea, more frequent, dizzy or irritable, or vomiting, lack of urination, is a case in point.
If you see dry skin, depression of the cardia, crying without tears, little or no urine, graying, and apathy, it is a critical change of diarrhea.
Distinguishing dysentery and diarrhea has a short course of disease, diarrhea and violent diarrhea, and a large amount of abdominal pain is mostly empirical.
The diarrhea is long and the diarrhea is slow.
Delays are difficult to heal for a long time, diarrhea may be urgent or slow, and those who refuse to press according to abdominal distension and pain are mostly insufficiency.
Second, the principle of treatment of diarrhea, the basic principle is to transport spleen and dampness.
In fact, the main treatment is to eliminate evil, according to different types of syndromes to eliminate stasis, eliminate wind and dispel cold, clear heat and dampness.
Deficiency is mainly based on righting, and the spleen is nourished and the spleen is warmed.
The diarrhea is transformed into a card, which can be treated with Yiqi Yangyin, sour and constricting Yin, protecting yin and yang, and reversing Gutu.
In addition to internal medicine, this disease is often treated with external treatment, massage, acupuncture and other methods.
Third, divide the card to discuss governance (a) the regular card 1.
Injury, food and diarrhea symptoms: thin stools, milk clots or food residues, sour smell, or swollen belly, such as broken eggs, abdominal pain in front of the stool, reduced pain after diarrhea, refusal to press abdominal pain, belching, orHave vomiting, do not think about breastfeeding, restless at night, thick greasy tongue, or slightly yellow.
Analysis: This card often has a history of inedible milk.
Insufficient milk food, damage to the spleen and stomach, and abnormal transport, so there is indigestible milk clots or food residues in the stool.
Stagnation in food stagnation, abdominal distension and abdominal pain due to unfavorable air-conditioning; post-diarrheal stagnation may be reduced, and the air-conditioning will be smooth for a while, so the abdominal pain after diarrhea is temporarily reduced.
Dairy internal rot, turbid gas up, stomach loss and lowering, belching, soreness, or vomiting.
Tongue fur is thick or slightly yellow, sour stools, or rotten eggs, do not think about milk, restless at night, are evidence of milk product stagnation.
Governing law: digestion and stagnation.
Recipe: Baohe Pills.
Commonly used medicines: Hawthorn, Divine Comedy, Laizizi digestion and accumulation of stagnant stagnation, Chenpi, Pinellia qi reduction and inverse, Poria spleen and spleen and dampness, Forsythia clearing and stagnation.
Abdominal bloating and abdominal pain with woody fragrance, Magnolia, betel nut, qi and qi, relieve pain and analgesia; vomiting with Huoxiang, ginger and stomach to stop vomiting.
Symptoms of wind cold and diarrhea: thin stools, foaming in the middle, low odor, intestinal pain and abdominal pain, or fever accompanied by aversion to cold, runny nose, cough, pale tongue, and thin white fur.
Analysis: Inadequate nursing care, feeling cold, cold cold in the stomach and intestines, cold stagnation, stagnation of qi, stagnation in Zhongyang, dereliction of duty, so I saw thin stools, foamy dung, and bad smell.
The wind is cold and stagnation, the air machine must not be unblocked, so I see bowel sounds and abdominal pain.
Aversion to cold, fever, nasal runny nose, cough, pale tongue, and thin white fur, replacing the external attack of wind and cold.
Governing Law: Disperse wind and dispel cold, dampen and moderate.
Recipe: Huoxiang Zhengqi Powder is added or subtracted.
Commonly used medicines: Huoxiang, Su Ye, Paeonia lactiflora, ginger, dispelling wind and dispersing cold, regulating gas and dampness, big abdomen skin, Magnolia officinalis, Chenpi, temperature and dryness and dampness of Pinellia, conditioning Qi machine, atractylodes, Poria, licorice, jujube healthSpleen and stomach.
Stools are thin, pale green, and foamy. Add wind charcoal to expelling wind and relieve diarrhea. Abdominal pain is severe, cold in the cold, add woody fragrance, and dry ginger to relieve cold and pain in the temperature of Daniel. If you have food stagnation, remove licorice, jujube, addJiao Hawthorn, Shenqu digestion and stagnation; lack of urine, plus diarrhea, soot and diuresis; epidermal cold plus nepeta, windproof to strengthen the ability to relieve the cold.
Symptoms of dampness, heat and diarrhea: watery stools, or like egg soup, urgency to diarrhea, frequent repeated doses, stinky odor, or foreign matter mucus, abdominal pain, loss of appetite, or vomiting, fatigue,Or fever, trouble, thirst, short yellow urine, red tongue, yellow greasy fur, slippery pulse.
Analysis: The evil of hot and humid, accumulates the spleen and stomach, bet in series, pass the loss of the company, so the diarrhea is thin like water, and the amount is repeated many times.
Moist stickiness, hot rush, hot and humid steaming, obstructing the stomach gas machine, so diarrhea urgency, yellow and stinky, or seeing mucus, abdominal pain, disturbed; wet spleen and stomach, so appetite loss,Even vomiting, exhaustion.
If accompanied by exogenous feelings, then fever; heat is heavier than wet, then thirsty; betting hot and humid, so the urine is short and yellow; red tongue, yellow greasy fur, slippery pulses, alternating signs of damp heat.
Governing Law: clearing away heat and dampness.
Recipe: Gegen Huanghuang Huanglian Decoction.
Commonly used medicines: Pueraria detoxifying fever, Shengjin Shengyang, Scutellaria baicalensis, Coptis clearing damp and heat of the stomach and intestines, licorice reconciling various medicines, all have the functions of clearing the intestines and clearing the inside and the outside.
Heat is heavier than wet, add forsythia, purslane, verbena to clear heat and detoxify; wet is heavier than heat, add talc, plantain, Poria, Atractylodes is dry and damp; abdominal pain with woody aroma and analgesia; thirst with plaster,Reed root clears heat and promotes heat; in the wet and turbid in summer, it is blocked by adding Huoxiang, Pei Lan fragrant and wet and turbid;
Spleen Deficiency Diarrhea Symptoms: Thin stools, pale color and no odor, more than diarrhea after eating, light and heavy, pale complexion, weight loss, tiredness, pale tongue and white fur, slow pulse.
Analysis: The spleen and stomach are weak, Qingyang does not rise, and Yunhua is dereliction of duty. Therefore, the stool is thin, the color is light and does not smell, and it is light and heavy.
The spleen and stomach are weak, and the right to accept is not available, so it is more than a diarrhea after eating.
Diarrhea is longer, the spleen is not transported, the skin is not clothed, the source of biochemistry is insufficient, the blood is not enough, so the complexion looks yellow, the body is thin, the fatigue is tired, the tongue is pale and white, and the pulse is weak.
Governing Law: Spleen Qi, help transport diarrhea.
Recipe: Shenling Baizhu Powder addition and subtraction.
Commonly used drugs: Codonopsis, Atractylodes, Poria, Licorice tonicate the spleen, Chinese yam, lotus meat, lentils, coix seed, spleen and dampness, Amomum vulgaris, platycodon qi and stomach.
Stomach appetite, greasy tongue, add fragrant incense, tangerine peel, coke hawthorn to aromatize wet, qi and digestion to help transport; abdominal distension and add woody fragrant, snail shell to dissipate qi; abdomen cold tongue, light stool, indigestible stool stoolFor indigestible matter, add dried ginger to disperse cold and warm the spleen to help transport; long-term diarrhea does not stop, there is no stagnant inside, add nutmeg, gardenia, pomegranate peel to stop diarrhea.
Symptoms of deficiency of spleen and kidney yang: diarrhea persists, stools are thin, and the valley is not melted, or anal prolapse, cold-shaped limbs are cold, complexion is pale, spirits are dizzy, eyes are light during sleep, tongue is pale and white, and veins are weak.
Analysis: Jiuxie not only, spleen and kidney yang deficiency, life-gate fire failure, can not warm the spleen soil, so the stool is thin, not finished.
Spleen deficiency and Qi depression, see prolapse.
Insufficient kidney yang, cold and endogenous, so cold limbs, pale complexion, apathetic, eyes exposed during sleep, pale tongue and white fur, weak pulse.
Governing method: nourishing the spleen and warming the kidney, solid astringent and reducing diarrhea.
Recipe: Aconite Lizhong Decoction plus Sishen Pill.
Commonly used drugs: Codonopsis, Atractylodes, licorice, strengthening spleen and qi, dry ginger, rutaecarpa, warm and cold, aconite, psoralea, nutmeg, schisandra, warming the spleen and warming the spleen, fixing astringent and diarrhea
· Anal prolapse plus deciduous astragalus, Cimicifuga lifts mid-air; Jiujia not only adds gardenia, pomegranate skin, erythrolipid, and astringent to stop diarrhea.
(2) Change of Certificate 1.
Symptoms of qi and yin injury: diarrhea inexhaustible, dilute as water, dispirited or upset, visual and sunken skin, dry or withered skin, crying without tears, drinking thirst, lack of urine, or even no urine, Lips red and dry, red tongue less Jin, little or no moss, pulse count.
Analysis: This card mostly originates from hot and humid diarrhea, due to insufficiency of diarrhea, loss of water and fluids, robbing of yin and jin, deficiency of fluid and qi, and loss of skin. Therefore, the eyes and anterior ridges are sunken, and the skin is dry or withered, cryingNo tears, red lips and dry lips.
Insufficient fluid, so short urine, or even no urine.
Stomach yin trauma, without Jinshou, so dry mouth, thirst to drink.
Insufficient qi and yin, upset the heart, so upset.
Tongue red and little Jin, little or no moss, pulse count, replacing the phenomenon of qi and yin injury.
Governing Law: Yi Qi Yang Yin, sour Gan convergence Yin.
Recipe: Ginseng Wumei Decoction.
Commonly used drugs: ginseng, licorice, qi and spleen, ebony astringent intestines and diarrhea, papaya to dampen the stomach and stomach, four medicines combined and can be used to sour yin, lotus seeds, yam, spleen and diarrhea.
Jiujia not only adds hawthorn charcoal, gardenia, and red stone to astringent intestines to quench thirst; thirst induces drink with Dendrobium, Yuzhu, Trichosanthin, reed root to nourish yin and thirst; thirst for stool and spleen heat to clear the inner content.
Symptoms of yin and yang dysfunction: more than one diarrhea, more frequent, weak spirits, indifferent expression, pale gray or pale, weak crying, crying without tears, little or no urine, cold limbs, pale tongue,The pulse sinks.
Analysis: This card is more common in diarrhea or long-term diarrhea, which consumes fluid, yin and yang, and qi is removed with fluid.
Yin hurt inside, so I saw crying without tears, little or no urine; Yang out of the outside, then the spirit is apathetic, indifferent expression, weak crying, pale gray or pale, cold limbs.
The tongue is pale, and the pulse is sinking, and the pulse is exhausted.
Governing Law: Reinvigorate Yin and Yang, and save Gu Gu.
Recipe: Shengmai San combined Shenfu Longmu Jiini Decoction.
Commonly used medicines: ginseng nourishing vitality, Ophiopogon japonicum, Schisandra chinensis, Paeonia lactiflora, sucrose nourishing yin and nourishing yin, sour yam and yin, aconite to solidify yang, keel, oyster Qianyang rescue.
[其他疗法] 一、中成药剂 1.Huoxiangzhengqi capsules take 2-3 capsules each time, 3-4 times a day.
For the cold and diarrhea.
Chunyang Zhengqi Pills are 2-3g per serving, 3-4 times a day.
For cold diarrhea, abdominal cold vomiting.
Manna disinfectant is 2-3g per serving, 3-4 times a day.
Diarrhea for summer dampness.
Gegenlinglian pills, 12 g per serving, 3-4 times a day.
For hot and humid diarrhea.
Fuzi Lizhong Wan 2-3g per serving, 3-4 times a day.
For spleen and kidney yang deficiency.
Second, unilateral prescriptions 1.
Cangzhu, Hawthorn in equal parts, charcoal retention, ground.
Take 1-2g each time, 3-4 times a day.
It has the function of transporting spleen and reducing diarrhea.
The spleen-yang injury caused by Jiujia is added with an equal portion of cannon ginger charcoal powder for spleen deficiency.
Almond and talc soup with almond, talc, 10g each for Pinellia ternata, Scutellaria baicalensis, Magnolia officinalis, 6g each for turmeric, 4g orange red, 3g each for Coptis chinensis and Licorice.
Decoction, 1 dose daily.
There are Xuan Changqi, clearing away dampness and heat, used for dampness and heat.
Third, external drug treatment 1.
2g cloves, 30g Evodia, 30 peppers.
1-3g each time, adjust the vinegar into a paste, apply to the umbilicus, once a day.
For the cold and diarrhea, spleen deficiency.
30g of Needleweed, add the right amount of water.
After boiling, pour into the basin, soak your feet before smoking, 3-5 times a day, use 3-5 days.
Various diarrhea for children.
Fourth, acupuncture therapy 1.
Acupuncture was taken at Zusanli, Zhongyu, Tianshu and Pishu.
Fever plus Quchi, vomiting plus Neiguan, upper sacrum, abdominal distension and chin, four wounds to the food and puncture, water samples will add more water.
In fact, the method of diarrhea is used and the method of deficiency is used 1-2 times a day.
The moxibustion method takes Zusanli, Zhongdi and Shenbi.
Ginger moxibustion or mild moxibustion, 1-2 times a day.
For spleen deficiency and diarrhea.
Fifth, massage therapy to transport the spleen, push the large intestine, clear the small intestine 100 times, rub the abdomen for 3 minutes, rub the Tianshu, rub the turtle tail, push the seven bones each 100 times, pinch the spine 3-5 times.
Fever plus retreat for six days, Qingtian river water, cold and damp and rubbing the laborer’s palace 100 times, dampness and heat plus clearing the large intestine 100 times, partial injury food and pushing the door 100 times, partial spleen deficiency and rubbing for three miles.
Six, diet therapy 1.
Stir-fried yam, barley kernel, and scallion can be used alone or together, and cooked with rice for daily consumption.
For spleen deficiency.
Eight spleen cakes for strengthening the spleen, 2 pieces each time, boiled water and eat into a paste, 1-3 times a day.
For spleen deficiency.
[预防护理] 一、预防. 1.Pay attention to food hygiene, food should be fresh, clean, do not eat spoiled food, do not overeating.
Wash your hands before and after meals and clean your tableware.
Promote breastfeeding, it is not appropriate to wean in summer and when children are sick, follow the principle of supplementary food, and pay attention to scientific alternatives.
Strengthen outdoor activities, pay attention to climate change, increase and decrease clothes in time, and prevent the abdomen from getting cold.
Second, nursing 1.
Properly control the diet to reduce the burden of high blood pressure. Children with severe vomiting and diarrhea can be temporarily fasted for 6-8 hours. After that, their condition will be improved and their diet will be gradually increased.
Avoid greasy, cold and indigestible food.
Keep your skin clean and dry, and change your diapers frequently.
After each bowel movement, wash the residue with warm water and pour on talcum powder.
Prevent red hips.
In-depth observation of changes in the condition to prevent diarrhea.
[文献摘要] 《小儿卫生总微论方·吐泻论》：“小儿吐泻者，皆由脾胃虚弱，乳哺不调，风寒暑湿，邪干于正所致也。”Book of Diarrhea · Diarrhea”: “Every diarrhea is wet.
There are five evidences, and the rule of law is mainly based on distribution and promotion, and cannot be mixed.
“Ancient and modern medical systems, young and young, and diarrhea.” “Ediarrhea is a disease of the spleen and stomach. Where diet, cold, and heat do not regulate this as an internal cause, it will cause diarrhea, and according to the” Nei Jing “, springColds, Xia Xun release; summer injury, summer injury, wet autumn, are external causes, but also cause diarrhea.
The healer should ask for it in the category, and there is no need to use a formula to stop the diarrhea, but the cloud can cure, but this is a mistake, is it a cloud ear?
If the cause is not cured, although the diarrhea is suspended and relapsed, the delay is long.
” [现代研究] 韩新民，叶进，袁斌，等.Clinical observation of Cangge Zhixie Granules in the treatment of infantile rotavirus enteritis.Journal of Nanjing University of Traditional Chinese Medicine 1997; 13 (6): 336 Cangge Zhixie Granules (composed of Cangzhu, Pueraria, Psyllium, Dijincao, Baiji, Licorice) for the treatment of infantile rotavirus enteritis damp-heat syndromeCases and 20 cases of Smecta control group.
Results The total effective rates of the two groups were 93.
0%, no significant difference in efficacy (P>, 0.
05); the antidiarrheal time of the two groups was 2.
6 soil 0.
85 days, 2.
8 soil 0.
At 75 days, there was no significant difference (P> 0.
However, the average time for rotavirus to turn negative after treatment in the treatment group was significantly shorter than that in the control group, and the treatment of concomitant symptoms such as fever, vomiting, and loss of appetite was significantly more effective than the control group.
At the same time, Cangge Zhixie Granules can increase the decreased serum superoxide dismutase and increase the level of peroxidized lipids in children with diarrhea, suggesting that Cangge Zhixie Granules may have the effect of scavenging free radicals.
Yang Shuoping, Ge Jianjun.
Report of 49 cases of Cryptosporidium infection treated by Quyin decoction in infants and young children.
Journal of Traditional Chinese Medicine 1994; 35 (1): 42 49 children with cryptosporidium enteritis, the shortest course of disease is 1 day, the longest is 1 year.
Use Qingyin Decoction: 6g each of Atractylodes root, Sophora flavescens and Baibu, log of white peony, betel nut and pueraria, 5so each of peel, barberry, licorice and thunder pill (below) can be added or subtracted with the card.
Decoction lOOinL and take it orally 3 times.
1 dose per day for 6 courses.
After 1 course of treatment, 47 cases were cured, and 2 cases were ineffective.